Credentialing Specialist

Company: ICONMA
Location: Southfield
Posted on: May 27, 2023

Job Description:

Job Description

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  Navigating and analyze credentialing data
  
  
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  Understanding and completing CMS Surveys and other documents for Organizational Providers
  
  
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  CAQH Intiatives
  
  
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  Evaluating and investigating practitioner and facility state licenses for actions, sanctions and/or malpractice claims history to process accordingly with summaries created in electronic file for presentations
  
  
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  Analyzing files to ensure compliance with recredentialing timelines and collaborate with Sr. Analysts to ensure alignment with the national CAQH VeriFide initiatives
  
  
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  Performing board certification and eligibility analysis and compare to rural health practitioner Excel spreadsheet to determine certification exception eligibility
  Qualifications:
  
  
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  Associates Degree
  
  
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  2-5+ years work experience in contracts or provider enrollment
  
  
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  Knowledge in NCQA, DIFS, and CMS
  As an equal opportunity employer, ICONMA prides itself on creating an employment environment that supports and encourages the abilities of all persons regardless of race, color, gender, age, sexual orientation, citizenship, or disability.
  
  

Keywords: ICONMA, Southfield , Credentialing Specialist, Other , Southfield, Michigan